By JAMES M. ODATO Capitol bureau

Published 12:00 am, Thursday, January 6, 2011

ALBANY -- Gov. Andrew Cuomo said New York is supposed to lead the nation with bold initiatives. But he is turning to the Midwest for ideas to control the state's extraordinarily large and complex public health insurance program.

In attempts to solve $41.8 billion in budget shortfalls projected over the next three years, Gov. Andrew Cuomo has recruited Jason Helgerson, a health finance professional from Wisconsin credited with helping that state tighten a bloated Medicaid system and create greater usage and more efficient programs.

Cuomo announced Helgerson will be the first-ever New York state Medicaid director. His task is to help redesign the $50 billion program and save about $2.1 billion in state funds -- or $4.2 billion, including federal matching funds, according to Dan Sisto, president of the Healthcare Association of New York State, who will serve on a "stakeholders" committee.

Helgerson will work with Jim Introne -- who served former Gov. Mario M. Cuomo as an aide -- and a committee of legislative, executive and the health care industry officials including union leaders and hospital representatives.

"We have seduced him to come join us," Cuomo said about Helgerson in the State of the State.

Helgerson's work in Wisconsin involved getting health care interests to help him find ways to cut a targeted sum of $633 million from Wisconsin's 2009-2011 budget, or about 10 percent of the entire Medicaid budget, which is funded evenly between state and federal dollars.

D'Anna Bowman, Wisconsin state director for the AARP, said Helgerson was instrumental in creating a more efficient and effective Medicaid program through cuts that were done cooperatively rather than controversially.

"What's gone on in the last two years in terms of Medicaid is exceptional; we are considered a model," Bowman said. She said family care programs have been retooled so that there is more money for home and family care rather than sending so much to nursing homes and other long-term institutions.

She said AARP and other interested parties worked with Helgerson to remake the program. Fully 98 percent of children in Wisconsin are currently under some form of health coverage. She said if she were a New Yorker, "I would be excited."

Providers and constituencies working with state officials found the cuts and charted progress with an innovative "dashboard of accrued savings" so that each month the group could monitor savings for a variety of medical procedures.

"They had more than 40 different ideas on reaching the projected savings," she said. For instance, C-section reimbursement rates were modified for $214,000 in savings in the first eight months of last year.

Cuomo wants the committee and Helgerson to begin working on Friday and report back by March 1 so that the savings plan can be part of the budget for next fiscal year. "I guess the challenge to do this is (having) 52 days to transform the Medicaid program," Sisto said. "It's going to be obviously an enormous undertaking."